Therapeutic effect of neurointervention assisted alteplase thrombolysis in the treatment of acute ischemic stroke
10.7683/xxyxyxb.2024.01.006
- VernacularTitle:神经介入辅助阿替普酶溶栓治疗急性缺血性脑卒中疗效观察
- Author:
Jicun WANG
1
;
Jianxin WANG
Author Information
1. 北京市顺义区医院神经疾病中心一病区,北京 101312
- Keywords:
acute ischemic stroke;
nerurointervention;
alteplase;
neurolin
- From:
Journal of Xinxiang Medical College
2024;41(1):32-36
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical effect of neurointervention assisted alteplase thrombolysis in the treatment of acute ischemic stroke(AIS).Methods A total of 104 AIS patients admitted to Beijing Shunyi Hospital from June 2022 to June 2023 were selected as the research subjects,and they were divided into observation group and control group according to the treatment method,with 52 cases in each group.The patients in the control group were treated with alteplase thrombolysis,and the patients in the observation group were treated with neurointervention assisted alteplase thrombolysis.The therapeutic effect of patients in the two groups was evaluated according to the National Institutes of Health stroke scale(NIHSS)score at two weeks after treatment.Before treatment and 3,7 days after treatment,the serum nerve growth factor(NGF),neuron specific enolase(NSE),central nervous system specific protein S100β levels of patients in the two groups were detected by enzyme-linked immunosorbent assay;the peak systolic velocities of common carotid artery,basilar artery and vertebral artery of patients in the two groups were detected by ultrasound transcranial Doppler blood analyzer;the degree of neurological damage of patients in the two groups was evaluated by NIHSS scores.The occurrence of drug-related adverse reactions during treatment of patients in the two groups were recorded;the comprehensive living ability of patients in the two groups was evaluated by improved Rankin score at three months after treatment.Results The total effective rates of patients in the control group and the observation group were 80.77％(42/52)and 96.15％(50/52),respectively;the total effective rate of patients in the observation group was significantly higher than that in the control group(x2=6.029,P＜0.05).There was no significant difference in the serum NGF,NSE,S100β levels of patients between the two groups before treatment(P＞0.05).Compared with before treatment,the serum NGF level of patients in the two groups increased,and the serum NSE,S100β levels decreased at 3,7 days after treatment(P＜0.05).At 3,7 days after treatment,the serum NGF level of patients in the observation group was significantly higher than that in the control group,and the serum NSE,S100β levels were significantly lower than those in the control group(P＜0.05).There was no significant difference in the peak systolic velocities of common carotid artery,basilar artery and vertebral artery of patients between the two groups before treatment(P＞0.05).The peak systolic velocities of common carotid artery,basilar arteryand vertebral artery of patients at 3,7 days after treatment were significantly lower than those before treatment in the two groups(P＜0.05).After 3,7 days after treatment,the peak systolic velocities of common artery,basilar artery,and vertebral artery of patients in the observation group were significantly lower than those in the control group(P＜0.05).There was no significant difference in NIHSS score of patients between the two groups before treatment(P＞0.05).The NIHSS score of patients at 3,7 days after treatment was significantly lower than that before treatment in the two groups(P＜0.05).At 3,7 days after treatment,the NIHSS score of patients in the observation group was significantly lower than that in the control group(P＜0.05).The total incidence of adverse reactions of patients during treatment in the control group and observation group was 7.69％(4/52)and 9.62％(5/52),respectively;there was no significant difference in the total incidence of adverse reactions during treatment of patients between the two groups(x2=0.000,P＞0.05).At 3 months after treatment,the comprehensive living ability of patients in the observation group was better than that in the control group(P＜0.05).Conclusion Neurointer-vention assisted with alteplase thrombolysis in the treatment of AIS patients can significantly improve the treatment efficacy and the expression of neurolin,reduce the degree of neurological impairment and improve comprehensive living ability,and has a certain degree of safety.
